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Villani R, Serviddio G, Avolio C, Cassano T, D'Amico E. Autoimmune liver disease and multiple sclerosis: state of the art and future perspectives. Clin Exp Med 2023; 23:3321-3338. [PMID: 37421590 PMCID: PMC10618321 DOI: 10.1007/s10238-023-01128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
Clinical observations suggest that the prevalence of autoimmune diseases is changing over time. Both autoimmune liver diseases and multiple sclerosis have shown a significant increase in the last decades. Although the coexistence of autoimmune diseases within individuals and families is a common phenomenon, the extent to which liver disease and multiple sclerosis co-occur is not clear. Case reports and few studies have reported the possible coexistence of multiple sclerosis with thyroid diseases, inflammatory bowel disease, psoriasis, and rheumatoid arthritis. It is unknown whether there is a definite association between multiple sclerosis and autoimmune liver diseases. We reviewed the literature to summarize the available studies on the association between different autoimmune liver diseases (autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis) and treated or untreated multiple sclerosis.
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Affiliation(s)
- Rosanna Villani
- Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Gaetano Serviddio
- Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Carlo Avolio
- Department of Medical and Surgical Sciences, Multiple Sclerosis Center, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Emanuele D'Amico
- Department of Medical and Surgical Sciences, Multiple Sclerosis Center, University of Foggia, Foggia, Italy
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2
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A large-scale investigation into the role of classical HLA loci in multiple types of severe infections, with a focus on overlaps with autoimmune and mental disorders. J Transl Med 2021; 19:230. [PMID: 34059071 PMCID: PMC8165335 DOI: 10.1186/s12967-021-02888-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Infections are a major disease burden worldwide. While they are caused by external pathogens, host genetics also plays a part in susceptibility to infections. Past studies have reported diverse associations between human leukocyte antigen (HLA) alleles and infections, but many were limited by small sample sizes and/or focused on only one infection. Methods We performed an immunogenetic association study examining 13 categories of severe infection (bacterial, viral, central nervous system, gastrointestinal, genital, hepatitis, otitis, pregnancy-related, respiratory, sepsis, skin infection, urological and other infections), as well as a phenotype for having any infection, and seven classical HLA loci (HLA-A, B, C, DPB1, DQA1, DQB1 and DRB1). Additionally, we examined associations between infections and specific alleles highlighted in our previous studies of psychiatric disorders and autoimmune disease, as these conditions are known to be linked to infections. Results Associations between HLA loci and infections were generally not strong. Highlighted associations included associations between DQB1*0302 and DQB1*0604 and viral infections (P = 0.002835 and P = 0.014332, respectively), DQB1*0503 and sepsis (P = 0.006053), and DQA1*0301 with “other” infections (a category which includes infections not included in our main categories e.g. protozoan infections) (P = 0.000369). Some HLA alleles implicated in autoimmune diseases showed association with susceptibility to infections, but the latter associations were generally weaker, or with opposite trends (in the case of HLA-C alleles, but not with alleles of HLA class II genes). HLA alleles associated with psychiatric disorders did not show association with susceptibility to infections. Conclusions Our results suggest that classical HLA alleles do not play a large role in the etiology of severe infections. The discordant association trends with autoimmune disease for some alleles could contribute to mechanistic theories of disease etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-02888-1.
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Antigen presentation, autoantibody production, and therapeutic targets in autoimmune liver disease. Cell Mol Immunol 2020; 18:92-111. [PMID: 33110250 PMCID: PMC7852534 DOI: 10.1038/s41423-020-00568-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
The liver is an important immunological organ that controls systemic tolerance. The liver harbors professional and unconventional antigen-presenting cells that are crucial for tolerance induction and maintenance. Orchestrating the immune response in homeostasis depends on a healthy and well-toned immunological liver microenvironment, which is maintained by the crosstalk of liver-resident antigen-presenting cells and intrahepatic and liver-infiltrating leukocytes. In response to pathogens or autoantigens, tolerance is disrupted by unknown mechanisms. Intrahepatic parenchymal and nonparenchymal cells exhibit unique antigen-presenting properties. The presentation of microbial and endogenous lipid-, metabolite- and peptide-derived antigens from the gut via conventional and nonconventional mechanisms can educate intrahepatic immune cells and elicit effector responses or tolerance. Perturbation of this balance results in autoimmune liver diseases, such as autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. Although the exact etiologies of these autoimmune liver diseases are unknown, it is thought that the disruption of tolerance towards self-antigens and microbial metabolites and lipids, as well as alterations in bile acid composition, may result in changes in effector cell activation and polarization and may reduce or impair protective anti-inflammatory regulatory T and B cell responses. Additionally, the canonical and noncanonical transmission of antigens and antigen:MHC complexes via trogocytosis or extracellular vesicles between different (non) immune cells in the liver may play a role in the induction of hepatic inflammation and tolerance. Here, we summarize emerging aspects of antigen presentation, autoantibody production, and the application of novel therapeutic approaches in the characterization and treatment of autoimmune liver diseases.
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Suppression of a broad spectrum of liver autoimmune pathologies by single peptide-MHC-based nanomedicines. Nat Commun 2019; 10:2150. [PMID: 31089130 PMCID: PMC6517389 DOI: 10.1038/s41467-019-09893-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/05/2019] [Indexed: 01/28/2023] Open
Abstract
Peptide-major histocompatibility complex class II (pMHCII)-based nanomedicines displaying tissue-specific autoantigenic epitopes can blunt specific autoimmune conditions by re-programming cognate antigen-experienced CD4+ T-cells into disease-suppressing T-regulatory type 1 (TR1) cells. Here, we show that single pMHCII-based nanomedicines displaying epitopes from mitochondrial, endoplasmic reticulum or cytoplasmic antigens associated with primary biliary cholangitis (PBC) or autoimmune hepatitis (AIH) can broadly blunt PBC, AIH and Primary Sclerosing Cholangitis in various murine models in an organ- rather than disease-specific manner, without suppressing general or local immunity against infection or metastatic tumors. Therapeutic activity is associated with cognate TR1 cell formation and expansion, TR1 cell recruitment to the liver and draining lymph nodes, local B-regulatory cell formation and profound suppression of the pro-inflammatory capacity of liver and liver-proximal myeloid dendritic cells and Kupffer cells. Thus, autoreactivity against liver-enriched autoantigens in liver autoimmunity is not disease-specific and can be harnessed to treat various liver autoimmune diseases broadly. Immune response against tissue-specific antigens is a hallmark of autoimmunity. Here the authors show that a single autoantigen-based nanomedicine can ameliorate pathology in a broad range of liver autoimmunity models without impairing host defenses, suggesting organ-wide tolerization.
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Oda H, Ishihara M, Miyahara Y, Nakamura J, Kozuka Y, Iwasa M, Tsunoda A, Yamashita Y, Saito K, Mizuno T, Shiku H, Katayama N. First Case of Cytokine Release Syndrome after Nivolumab for Gastric Cancer. Case Rep Oncol 2019; 12:147-156. [PMID: 31043953 PMCID: PMC6477485 DOI: 10.1159/000496933] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Cytokine release syndrome (CRS) is a potentially life-threatening systemic disease that has been observed after treatment with antibodies and adoptive T cell therapies. In this case, we observed nivolumab-induced CRS in a patient with gastric cancer. Case Presentation A 43-year-old male with advanced gastric cancer was treated with nivolumab as a third-line chemotherapy. He had no history of allergies. Eight days after the first administration of nivolumab, fever, tachycardia, appetite loss and increases in liver and biliary enzymes were observed. Computed tomography revealed neither bile duct obstruction nor progression of liver metastases but showed that there was edema of the Gleason sheath. Histopathological analysis of the liver revealed cholestatic liver injury with CD8+ T lymphocyte and macrophage infiltration. Neither viral infection nor autoimmune disease was revealed. His symptoms were similar to those of CRS observed after T cell therapy. We diagnosed his disease as nivolumab-induced liver injury and cholangitis accompanied by CRS based on his serum cytokine levels. Discussion/Conclusion To the best of our knowledge, this is the first report of nivolumab-induced CRS in a patient with gastric cancer.
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Affiliation(s)
- Hiroyasu Oda
- Department of Medical Oncology, Mie University Hospital, Mie, Japan
| | - Mikiya Ishihara
- Department of Medical Oncology, Mie University Hospital, Mie, Japan
| | - Yoshihiro Miyahara
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Mie, Japan
| | - Junko Nakamura
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Mie, Japan
| | - Yuji Kozuka
- Department of Pathology, Mie University Graduate School of Medicine, Mie, Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology, Mie University Graduate School of Medicine, Mie, Japan
| | - Akira Tsunoda
- Department of Medical Oncology, Mie University Hospital, Mie, Japan
| | | | - Kanako Saito
- Department of Medical Oncology, Mie University Hospital, Mie, Japan
| | - Toshiro Mizuno
- Department of Medical Oncology, Mie University Hospital, Mie, Japan
| | - Hiroshi Shiku
- Department of Immuno-Gene Therapy, Mie University Graduate School of Medicine, Mie, Japan
| | - Naoyuki Katayama
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan
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Karra VK, Chowdhury SJ, Ruttala R, Gumma PK, Polipalli SK, Chakravarti A, Kar P. HLA-DQA1 & DQB1 variants associated with hepatitis B virus-related chronic hepatitis, cirrhosis & hepatocellular carcinoma. Indian J Med Res 2018; 147:573-580. [PMID: 30168489 PMCID: PMC6118146 DOI: 10.4103/ijmr.ijmr_1644_15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background & objectives: Clinical outcome after hepatitis B virus (HBV) exposure varies extremely from spontaneous clearance to chronic hepatitis B and often progresses to liver cirrhosis (LC) and hepatocellular carcinoma (HCC). Host genetic factor plays an important role in the regulation of immune response. This study was aimed to investigate whether HLA class II DQA1 and DQB1 gene polymorphism were associated with chronic hepatitis B infection and in the development of HBV-related LC and HCC. Methods: DQA1 and DQB1 allele polymorphism were studied in 187 patients with HBV-related liver diseases (which included 73 chronic hepatitis B, 84 LC and 30 HCC patients) and 109 controls who had spontaneously recovered from HBV infection using polymerase chain reaction amplification with sequence-specific primers. Results: Our data suggested that DQA1*0101/2/4 [odds ratio (OR)=2.78; Pc=0.003], DQA1*0103 (OR=2.64; Pc=0.0007) and DQB1*0302/3 (OR=2.15; Pc=0.01) were associated with the protection from chronic HBV infection, whereas DQB1*0402 (OR=0.25; Pc=0.001) showed susceptible effect on chronic HBV infection. DQB1*0601 (OR=3.73; Pc=0.006) conferred protective effect from developing LC; similarly, DQB1*0302/3 (OR=5.53; Pc=0.05) and DQB1*0402 (OR=0.00; Pc=0.001) conferred protective effect from developing HCC. However, DQA1*0601 and DQB1*0503 showed susceptible effect on chronic HBV infection; these associations were no longer significant after Bonferroni correction. Interpretation & conclusions: Our results revealed HLA-DQA1*0101/2/4 - DQA1*0103 - DQB1*0302/3 and DQB1*0601 as protective and DQB1*0402 as risk alleles. The study suggests that various subtypes of HLA-DQA1 and DQB1 are associated with both HBV clearance and development of chronic HBV infections.
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Affiliation(s)
- Vijay Kumar Karra
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Soumya Jyoti Chowdhury
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Rajesh Ruttala
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Phani Kumar Gumma
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Sunil Kumar Polipalli
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Anita Chakravarti
- Department of Medical Microbiology, Maulana Azad Medical College, University of Delhi, New Delhi, India
| | - Premashis Kar
- Department of Medicine, PCR Hepatitis Laboratory, Maulana Azad Medical College, University of Delhi, New Delhi, India
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Bali G, Szilvási A, Inotai D, Varga Á, Sárdy M, Kárpáti S, Medvecz M, Szegedi A, Hidvégi B. Comorbidity of localized scleroderma and primary biliary cholangitis. J Dtsch Dermatol Ges 2018; 16:1323-1327. [DOI: 10.1111/ddg.13693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 04/28/2018] [Accepted: 05/04/2018] [Indexed: 01/13/2023]
Affiliation(s)
- Gábor Bali
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Anikó Szilvási
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Dóra Inotai
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Ágnes Varga
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Miklós Sárdy
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Sarolta Kárpáti
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Márta Medvecz
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Anna Szegedi
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Bernadett Hidvégi
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
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Bali G, Szilvási A, Inotai D, Varga Á, Sárdy M, Kárpáti S, Medvecz M, Szegedi A, Hidvégi B. Komorbidität von lokalisierter Sklerodermie und primär biliärer Cholangitis. J Dtsch Dermatol Ges 2018; 16:1323-1328. [DOI: 10.1111/ddg.13693_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Gábor Bali
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Anikó Szilvási
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Dóra Inotai
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Ágnes Varga
- Hungarian National Blood Transfusion Service; Transplantation Immunogenetics Laboratory; Budapest Hungary
| | - Miklós Sárdy
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Sarolta Kárpáti
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Márta Medvecz
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Anna Szegedi
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
| | - Bernadett Hidvégi
- Department of Dermatology; Venereology and Dermato-Oncology; Faculty of Medicine; Semmelweis University; Budapest Hungary
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Ge W, Jiao Y, Chang L. The association between MTHFR gene polymorphisms (C677T, A1298C) and oral squamous cell carcinoma: A systematic review and meta-analysis. PLoS One 2018; 13:e0202959. [PMID: 30142181 PMCID: PMC6108503 DOI: 10.1371/journal.pone.0202959] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/13/2018] [Indexed: 01/10/2023] Open
Abstract
A consensus has not been reached regarding the association of MTHFR gene polymorphism and susceptibility to oral squamous cell carcinoma (OSCC). We performed a meta-analysis to better evaluate the association between MTHFR C677T, A1298C polymorphism and OSCC risk. The studies regarding the association of MTHFR C677T, A1298C polymorphisms and OSCC were identified in PubMed and EMBASE and Google Scholar. The pooled odd rates (ORs) with 95%CIs were estimated using a fixed-effect or random-effect model. The associations between MTHFR polymorphisms and OSCC risk were assessed under the dominant, recessive and additive models. A collective total of 1539 OSCC patients and 2131 normal controls were included across 13 studies. The minor T allele of MTHFR C677T was significantly associated with the increased risk of OSCC development(OR = 1.35, 95%CI 1.04-1.76). Individuals carrying the ''T" allele (TT+CT) had a nearly 43% increased risk for OSCC development when compared with CC (OR = 1.43, 95%CI 1.02-1.99). Under additive model, the results also showed that individuals with CT or TT genotype were more susceptible to OSCC than CC (OR = 1.45, 95%CI 1.02-2.08; OR = 1.79, 95%CI 1.28-2.50; respectively). The subgroup analysis by ethnicity revealed that significant difference in C677T allele distribution could be observed in European (OR = 1.33, 95%CI 1.02-1.75) rather than Asian (OR = 1.59, 95%CI 0.91-2.78). No significant association of MTHFR A1298C polymorphism and OSCC risk could be observed. The present study revealed that T allele and TT genotype of MTHFR C677T polymorphism were significantly associated with the increased risk of OSCC development.
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Affiliation(s)
- Wenzhang Ge
- Department of Special Clinic, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
| | - Yang Jiao
- Department of Medicine and Education, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
| | - Lianzhen Chang
- Department of Periodontics and Oral Medicine, Jinan Stomatological Hospital, Jinan, Shandong, P.R. China
- * E-mail:
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Reshetnyak VI. Primary biliary cirrhosis: Clinical and laboratory criteria for its diagnosis. World J Gastroenterol 2015; 21:7683-708. [PMID: 26167070 PMCID: PMC4491957 DOI: 10.3748/wjg.v21.i25.7683] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 04/07/2015] [Accepted: 06/10/2015] [Indexed: 02/06/2023] Open
Abstract
Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic granulomatous, and destructive inflammatory lesion of small intralobular and septal bile ducts, which is likely to be caused by an autoimmune mechanism with a the presence of serum antimitochondrial antibodies and a potential tendency to progress to cirrhosis. Despite the fact that the etiology of this disease has been unknown so far, there has been a considerable body of scientific evidence that can reveal the clinical and laboratory signs of PBC and the individual components of its pathogenesis and elaborate diagnostic criteria for the disease and its symptomatic therapy. Deficiencies in autoimmune tolerance are critical factors for the initiation and perpetuation of the disease. The purpose of this review is to summarize the data available in the literature and the author’s findings on clinical and laboratory criteria for the diagnosis of PBC. This review describes the major clinical manifestations of the disease and the mechanisms of its development. It presents the immunological, biochemical, and morphological signs of PBC and their significance for its diagnosis. A great deal of novel scientific evidence for the problem of PBC has been accumulated. However, the inadequate efficiency of therapy for the disease lends impetus to the quest for its etiological factors and to further investigations of its pathogenetic mechanisms and, on this basis, to searches for new methods for its early diagnosis.
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Strock SB, Gaudieri S, Mallal S, Yu C, Mitchell D, Cogan J, Mason W, Crowe D, Loyd JE. Fibrosing mediastinitis complicating prior histoplasmosis is associated with human leukocyte antigen DQB1*04:02 - a case control study. BMC Infect Dis 2015; 15:206. [PMID: 25940591 PMCID: PMC4424560 DOI: 10.1186/s12879-015-0943-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/27/2015] [Indexed: 02/06/2023] Open
Abstract
Background Fibrosing mediastinitis (FM) is an idiosyncratic reaction to infection with Histoplasma capsulatum with a prevalence of 3:100,000 people infected. The rarity of post-histoplasmosis fibrosing mediastinitis (PHFM) in areas where H. capsulatum is endemic suggests that an abnormal immunological host response may be responsible for the development of fibrosis. Our group previously reported an association between subjects with PHFM and human leukocyte antigen (HLA)-A*02. We sought to confirm or extend those findings with application of high resolution HLA typing in a cohort of subjects with PHFM. Methods High-resolution HLA typing was performed on DNA samples from a new cohort 34 patients with PHFM. Control cohorts included 707 subjects from the “European American” subset of the National Marrow Donor Program® (NMDP) and 700 subjects from Dialysis Clinic, Inc. (DCI). The carriage frequencies of the HLA alleles identified in the PHFM, NMDP, and DCI cohorts were calculated and then all were compared. Results We found an increase in the carriage frequency of HLA-DQB1*04:02 in PHFM subjects relative to the controls (0.15 versus 0.07 in DCI and 0.05 in NMDP; p = 0.08 and 0.03). Multiple logistic regression showed that DQB1*04:02 was statistically significant (p = 0.04), while DQB1*03:02 and C*03:04 had point estimates of OR > 1, though they did not reach statistical significance. The HLA-A*02 association was not replicated. Conclusions HLA-DQB1*04:02 is associated with PHFM, which supports the premise that an aberrant host immune response contributes to the development of PHFM.
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Affiliation(s)
- Stephen B Strock
- Department of Medicine, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Silvana Gaudieri
- School of Anatomy, Physiology and Human Biology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,Institute for Immunology & Infectious Disease, Murdoch University, Health Research Centre, Discovery Way, Murdoch, WA, 6150, Australia.
| | - Simon Mallal
- Institute for Immunology & Infectious Disease, Murdoch University, Health Research Centre, Discovery Way, Murdoch, WA, 6150, Australia. .,Department of Infectious Disease and Pathology, Microbiology and Immunology, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Chang Yu
- Department of Biostatistics, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Daphne Mitchell
- Pulmonary and Critical Care Medicine, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Joy Cogan
- Division of Medical Genetics and Genomic Medicine, Department of Pediatrics, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Wendi Mason
- Pulmonary and Critical Care Medicine, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
| | - Deborah Crowe
- DCI Laboratory - Transplant Immunology, 1616 Hayes St, Nashville, TN, 37203, USA.
| | - James E Loyd
- Pulmonary and Critical Care Medicine, Vanderbilt University, 1211 Medical Center Dr, Nashville, TN, 37232, USA.
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